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99% of the charge is NOT the item itself...but the ADMINISTRATION OF THAT ITEM. You are paying for the expertise and time of those who give that item to you or put that item on you. That item may go through many hands before it gets to you. Each person who has spent time and has to be paid.[
I get what you're saying. My complaint is that if she needs a sling and that level of expertise then why does the insurance company claim she doesn't need a sling at all?
And when it comes to something like a sling I'm pretty capable of putting it on myself. When I hired a landscaper and told him I wanted to keep my cost down he told me he could knock $500 off if I ripped out all the old landscaping myself......
I may not be qualified to put a cast on but can handle a sling or an aspirin.
As to your point about "are hospitals greedy?" ----- It isn't just the hospital it's all the sub-contractors they use. The hosptial may charge fair prices, their pharmacy may be cheap, and yet the X-ray company bill at twice the fair price. There isn't much incentive for the hospital to oversee the sub contractors billing policy.
Without a single point of responsibility there isn't anyone responsible but me.....
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Public Option To Cut Health Costs? Medicare's Record Says Dream On By JEFFREY H. ANDERSON Posted 06/19/2009 05:39 PM ET 'First, the rising cost of health care must be brought down." That's what President Obama recently declared when outlining the basic principles of his health care plan. His supporters have echoed his emphasis. The New York Times writes that, when it comes to health policy, "The president's main focus is on starting to reduce the soaring cost of health care." Speaker Pelosi concurs: Health care reform "is about cost — taking down the cost of health care." But can the president's plan succeed, even on his own terms? If history is any guide, it cannot — and will instead make matters much worse. The centerpiece of President Obama's plan is a "public option," described by Tom Daschle as "a government-run insurance program, modeled after Medicare." The president asserts that this new Medicare-like program would cut costs. But there are nearly 40 years of experience to consult, and they offer a resounding rebuttal. Across the years, Medicare's costs have risen far more than the costs of privately purchased care. A new study I've completed, published by the Pacific Research Institute, takes all health-care spending in the United States and subtracts the costs of the two flagship government-run programs, Medicare and Medicaid. It then takes that remaining spending and compares its cost increases over time with Medicare's cost increases over time. The results are clear: Since 1970 — even without the prescription drug benefit — Medicare's costs have risen 34% more, per patient, than the combined costs of all health care in America apart from Medicare and Medicaid, the vast majority of which is purchased through the private sector. Since 1970, the per-patient costs of all health care apart from Medicare and Medicaid have risen from $364 to $7,119, while Medicare's per-patient costs have risen from $368 to $9,634. Medicare's costs have risen $2,511 more per patient. These conclusions are true despite very generous treatment of Medicare. My study counts Medicare's prescription drug expenditures as part of privately purchased care, rather than as part of Medicare. It counts health care purchased privately by Medicare and Medicaid beneficiaries (including Medicare copayments and Medigap insurance) among the costs of private care, without counting its recipients among those receiving private care — thereby magnifying private care's per-person costs. And it doesn't adjust for cost-shifting from Medicare to private entities. The New York Times and others have quoted studies claiming that private insurance has failed to contain costs as well as Medicare. Such studies are deeply misleading, for they omit any consideration of out-of-pocket spending, thereby neglecting a major shift in the private health care market. From 1970 to 2007, out-of-pocket expenditures dropped from 62% of all private health care to just 26%. Correspondingly, insurance expenditures increased from 38% to 74%. These studies make no allowance for that change. That's a lot like looking at LP or CD sales, ignoring MP3s, and concluding that Americans are no longer as fond of music. The president himself says that "over the last decade" Americans "have seen their out-of-pocket expenses soar." But, according to official government figures, per-patient out-of-pocket costs have risen only 35% since 2000, while Medicare's per-patient costs have risen 59% — again, even without the prescription drug benefit. Private insurance and private out-of-pocket spending, in tandem, have controlled costs far better than Medicare. However, if Medicare has, in fact, fared comparatively well vs. private insurance — as the supporters of President Obama's proposals claim — then that means it has fared particularly poorly vs. private out-of-pocket spending, thereby further strengthening the argument that private consumers, paying out-of-pocket, are the best bargain-shoppers and the keenest pursuers of value in health care. From a policy perspective, this would suggest that the key to lowering costs is to let consumers control more of their own resources — that when they have the freedom and incentive to pursue value, they know how to keep costs down. The most important comparison, in the context of the current debate over a Medicare-like "public option," is between government-run health care and privately purchased health care on the whole. Across nearly four decades, Medicare's costs have risen more than one-third more, per patient, than the combined costs of all health care nationwide apart from Medicare and Medicaid. This is true even when viewing Medicare's costs in a charitable light. President Obama asserts that creating a Medicare-like "public option" is the way to slow the rising costs of health care. Experience shows the opposite, that costs have risen faster under government-run care. As Benjamin Franklin and George Mason argued at the Constitutional Convention, let's defer to "experience, the best of all tests." http://www.investors.com/NewsAndAnalysis/Article.aspx?id=480067
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BACK TO THE CAMPAIGN TRAIL By Neal Boortz @ June 23, 2009 8:21 AM If there is one thing that Barack Obama can do really well it is campaign. I really hoped that this guy would make just as good a president as he was a candidate, but sadly that doesn't seem to be the case. But that's another story. Now that he is in the White House, he is going to use his excellent campaign techniques to get legislation passed. In this case, it would be government-run healthcare. Yep. He is going to use his campaign slogan of "yes we can" to con the government-educated Americans into believing that government healthcare is exactly what they need in their lives. He said that those "here in Washington who've grown accustomed to sky-is-falling prognoses and the certainties that we cannot get this done, I have to repeat and revive an old saying we had from the campaign: 'Yes, we can.'" "Yes we can" make the dumb masses react positively to another focus-group based sloganeering campaign. "Yes we can" take control of another 20% of the American economy. "Yes we can" gain even more control over you by controlling your access to health care. "Yes we can" ration health care. "Yes we can" make the necessary excuses when this whole thing turns into dog squeeze. We'll blame what's left of the private sector. "Yes we can" stifle innovation in health care for the rest of time. "Yes we can" create long waiting lines for seeing a specialist. "Yes we can" make it seem as if there are only two MRI units in the entire nation "Yes we can" make the Canadians feel better knowing that misery loves company "Yes we can" successfully ignore the private sector's role in health care. "Yes we can" help to bury the people the people who die because their access to health care was limited due to their age. "Yes we can" run your health care like we've run Social Security and Medicaid. "Yes we can" fool most of the people in this country ... most of the time. Gag me. The only thing that is missing is the "change we can believe in" banner underneath. I'm sure that one is coming. After all, "change" is such a hot buzz word with voters. http://boortz.com/nealz_nuze/index.html
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$5 for the asprin...goes to pay for the RN nurses wage that gets the medication, it goes to the doctor that wrote the script for the Asprin, it goes to the over head of the hospital, etc...
Is $5 a lot for Asprin? Hell yeah it is. But the reason it is so much cheaper when you buy it OTC at the store is because you are not paying for those above mentioned costs when receiving an asprin at the hospital.
One could argue than why do you have to have a script to receive an asprin when in the hospital? If a script wasn't needed for such a drug it would be cheaper. And one could argue that mal practice suits are part of the reason for such practices. Well, why would one sue? They'd sue because that asprin interacted with another medication or that asprin thinned out the blood of a patient that resulted in more problems. And to avoid further mal practice suits they decided to implement a policy stating a script is needed for all medications. Now I'm not speaking as this is exactly how the practice came into a effect. I'm just pointing out the underlying reasons for a higher priced tablet of asprin in the hospital versus OTC in the store. Its not always about greed by the hospital, or the drug company, or the manufactorer of some machine. High prices come from policies instituted to protect patients and the hospital. I'm not saying this is the only reason. I'm just saying its one of the reasons. I'm also not saying greed isn't a factor. I'm just saying its not the only factor. I'm not saying the current system is perfect. I'm saying that if we truely want change, than creating a government healthcare or government reform is not the answer. We need to understand EVERY SINGLE mechanism into the reason things are the way they are. From the responsibility of citizens/patients to the responsibilities of hospitals/vendors/etc...
Trying to push through reform of this magnitude "now before its too late" is very very irresponsible. Especially when your talking about trillions of dollars.
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It's not like the doctors do crap on purpose to kill people. And that's what people need to realize.
Wrong sir.. not only should we expect them to be perfect, we should expect them to be perfect, work long hours, hold peoples lives in their hands, go to school until they are 30, amass hundreds of thousands of dollars in loans, be 100% accountable for any and all mistakes they make and pay millions to anybody affected by those mistakes...... and they should do it all for an average joe wage... at least that's what I'm getting out of this thread. 
yebat' Putin
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"Yes We Can"...  Good posts Jules.
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It's not like the doctors do crap on purpose to kill people. And that's what people need to realize.
Wrong sir.. not only should we expect them to be perfect, we should expect them to be perfect, work long hours, hold peoples lives in their hands, go to school until they are 30, amass hundreds of thousands of dollars in loans, be 100% accountable for any and all mistakes they make and pay millions to anybody affected by those mistakes...... and they should do it all for an average joe wage... at least that's what I'm getting out of this thread.
I feel ya.
And damn those drug companies for spending millions upon millions of dollars on research by men who have gone to Universities amassing similar debt as doctors...and than asking to be paid for their hard expensive work.
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Is $5 a lot for Asprin? Hell yeah it is. But the reason it is so much cheaper when you buy it OTC at the store is because you are not paying for those above mentioned costs when receiving an asprin at the hospital.
I'm pretty sure I could cook up a good steak, a baked potato, a small salad and a beer for about $8-9 at home... something comparable in a decent restaurant is going to cost me $30 at least.....
So why is it so hard for some people to figure out that an aspirin is going to cost a whole lot more at a hospital?
yebat' Putin
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OK here is another problem.....What is a fair price for an X-Ray?
Do you know what it costs to build, use, maintain a single X-Ray machine? Do you know what it costs to store the image? Do you know what it costs to pay the people to maintain the equipment to store that image? Do you know what that equipment costs?
Look at it this way. The ENTIRE Library of Congress would probably fit on about 20 TB of storage. Thats EVERYTHING...The Cleveland Clinic alone goes through well over 150 TB of storage EVERY YEAR, just for things like X-Rays, CT's, MRI's, etc......just image data...no patient data or dictations or anything les like that...JUST image data. Then they have to have machines that Store that information, make that information available to the docs and radiologists who need it, they have to have databases and applications that manage the images and data that go along with them, they have to have High Powered Graphics machines to view the images. All of this has to be supported. And we didn't even get to the people who actually performed the X-Ray itself....
So.....whats a fair price for an X-Ray??? You see this is another problem...People don't know what is involved. And they don't understand the magnitude of support that goes behind their service. All they see is a bill in front of them. They only know how it effects them. But just because they think an X-Ray should be worth only $20 (exaggerated # to makle a point) it doesn't make it so.
I thought I was wrong once....but I was mistaken...
What's the use of wearing your lucky rocketship underpants if nobody wants to see them????
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j/c I havnt read anything about fmla?...This is soo used, I know a guy who got it for kidney stone's  Any thought's?
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I don't think anyone really blames the hospital for the outrages bills, as much as understand the hospital is almost forced to charge exorbitant prices to account for unpaid bills, lawsuits, and insurance company haggling, malpractice insurance, and other extreme overhead costs due to regulations(which usually came from the government). So, let's fix the source of the problems. And letting the government pick and choose what and how much they will pay for things is NOT the answer. Heck I'd sign a waiver of responsibility to get a 40-50% discount each visit. 
Last edited by FloridaFan; 06/23/09 12:36 PM.
We don't have to agree with each other, to respect each others opinion.
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You realize I'm not sitting on a rock wearing a bear skin holding a club, right??
I'm not complaining about the "cost" of an X-ray. I'm complaining that the exact same facility has three different prices for the same X-ray. I'm complaining that the process fo getting one X-ray (or set) will involve no less that 10-12 bills.
This is my daughter's second broken arm in two years. In some ways I'd be happier to walk out of the ER with a bill that says $5,000 but that's not how it works. Bills trickle in for months and if you haven't already been through it you have no idea when it's going to end.
Bills just keep showing up so you pay the first set. Then more show up, so you call them and ask what they are. When you eventually talk to a live person all they tell you is that you'd have to talk to the Dr or Technician directly. - Like that's going to happen in a timely manner .
I'm fairly well off financially compared to many. If a broken arm costs $5,000 and that's a typical price - then I can live with that. The current model where bills you don't understand just keep coming, and when you call they can't be explained doesn't work for me.
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Is $5 a lot for Asprin? Hell yeah it is. But the reason it is so much cheaper when you buy it OTC at the store is because you are not paying for those above mentioned costs when receiving an asprin at the hospital.
I'm pretty sure I could cook up a good steak, a baked potato, a small salad and a beer for about $8-9 at home... something comparable in a decent restaurant is going to cost me $30 at least.....
So why is it so hard for some people to figure out that an aspirin is going to cost a whole lot more at a hospital?
Because the government isn't offering free steaks...
oh wait they do via food stamps. 
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You realize I'm not sitting on a rock wearing a bear skin holding a club, right??
LOL...Yes I do...hence the word "People" as opposed to using the word "you" 
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So.....whats a fair price for an X-Ray??? You see this is another problem...People don't know what is involved.
I can understand your frustration. and I can only say that hopefully the advances in the EMR(Electronic Medical Record) that are being made can help alleviate much of this. But I do think much of this is bottleneck is in entire billing process itself in which I include the insurance company. Because before it has even gotten to you the bill has probably bounced back and forth like a ping pong ball between the hospital and the insurance companies... 
As Chiefs was pointing out there has been a ton of legislation that has been made and remade and remade again that has shaped the way Hospitals can do the slightest of things. And frankly it is not the most convenient for the patient. Even if all the legislation was made to protect said patient. And of course we can seethe future....more legislation is on the ay to muck it up even more....
I thought I was wrong once....but I was mistaken...
What's the use of wearing your lucky rocketship underpants if nobody wants to see them????
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and they should do it all for an average joe wage... at least that's what I'm getting out of this thread.
Where does this 'average Joe wage' idea come from?
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and they should do it all for an average joe wage... at least that's what I'm getting out of this thread.
Where does this 'average Joe wage' idea come from?
Most specifically from Barf who thinks that everybody involved in healthcare should take big paycuts because they all make too much money... especially the evil doctors.
yebat' Putin
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The current model where bills you don't understand just keep coming, and when you call they can't be explained doesn't work for me.
I've gotten bills up to 9 months after service...My dad lived with us for some time before he passed...bills came in for several months..One bill we called on we asked what service you did for my dad on Nov 20th... They ran of a list of things...i asked if they had any problems with the test...they said no... they changed tune alittle when i told them my dad died in Oct....and we still had to fight that bill....
nordawg
The only reason people get lost in thought is because it's unfamiliar territory.
#gmstrong
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I'll quote myself... Quote:
I'm not saying they shouldn't earn more than most... I'm just saying they should earn less than they do now.
Making 150 a year instead of 200 while their costs of doing "business" goes down is not saying they should be paid like average joes.
"I'm a mog. Half man, half dog. I'm my own best friend."
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WASHINGTON (AP) -- President Barack Obama on Tuesday squared off with the U.S. insurance lobby over industry charges that a government health plan he backs would dismantle the employer coverage Americans have relied on for a half century and overtake the system. The harsh exchange came after months of polite White House photo events at which the administration and insurers emphasized their search for common ground. It happened just when Congress seems to be floundering in its attempt to move sweeping legislation embodying Obama's top domestic priority, although leading lawmakers say they remain confident. "If private insurers say that the marketplace provides the best quality health care ... then why is it that the government, which they say can't run anything, suddenly is going to drive them out of business?" Obama said in response to a question at a White House news conference. "That's not logical," he scoffed, responding to an industry warning that government competition would undermine the employer coverage. At issue is whether to set up a government-sponsored health insurance plan that would compete with private companies. Individuals and small businesses would get to pick either the public plan or a private one through a new kind of insurance purchasing pool called an exchange. Eventually, the exchanges could be opened to large companies as well. The United States is the only developed nation that does not have a comprehensive health care plan for all its citizens and roughly 50 million of 300 million Americans are without insurance. The government provides health care to the poor, the elderly and some veterans , but most Americans rely on private insurance through their employers. However, not all employers provide insurance and not everyone can afford to buy it on their own. "The public plan, I think, is an important tool to discipline insurance companies," Obama said. That is not what the industry thinks. In a letter to senators released Tuesday, the two largest industry groups warned in stark terms that a government plan would take over the system. America's Health Insurance Plans and the Blue Cross Blue Shield Association also said they do not believe it is possible to design a government plan that can compete fairly with private companies in a revamped health care market. That particular statement seemed to be aimed at lawmakers of both parties who continue to seek a compromise on the contentious issue. "We do not believe that it is possible to create a government plan that could operate on a level playing field," said the insurers' letter, signed by AHIP head Karen Ignagni and Scott Serota, the Blue Cross chief executive. " Regardless of how it is initially structured, a government plan would use its built-in advantages to take over the health insurance market." The industry suggested a government plan would run counter to Obama's promise that Americans can keep the coverage they have. "A government-run plan no matter how it is initially structured would dismantle employer-based coverage, significantly increase costs for those who remain in private coverage, and add additional liabilities to the federal budget," said the letter. Nonetheless, recent media polls have found strong public support for the idea. That has emboldened liberals, who are arguing that Democrats should not compromise on a government plan. But moderate Democrats in the Senate are trying to get Republican support for the idea of nonprofit co-ops as an alternative. Without a compromise, there probably will not be any significant Republican backing for Obama's plan to slow increases in health care costs and expand coverage to the nearly 50 million uninsured. web page
Thomas - The Tank Engine
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"If private insurers say that the marketplace provides the best quality health care ... then why is it that the government, which they say can't run anything, suddenly is going to drive them out of business?" Obama said in response to a question at a White House news conference.
"That's not logical," he scoffed, responding to an industry warning that government competition would undermine the employer coverage.
Cause he's an idiot and can't understand that a business owner isn't going to pay for or subsidize something his employees can get for free from the government.
We don't have to agree with each other, to respect each others opinion.
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"If private insurers say that the marketplace provides the best quality health care ... then why is it that the government, which they say can't run anything, suddenly is going to drive them out of business?" Obama said in response to a question at a White House news conference.
"That's not logical," he scoffed, responding to an industry warning that government competition would undermine the employer coverage.
Cause he's an idiot and can't understand that a business owner isn't going to pay for or subsidize something his employees can get for free from the government.
Exactly. Didn't Hawaii try doing a child healthcare system that nearly bankrupted the state? They had to ditch it because people that previously had private insurance chose to get the "free" healthcare instead. I believe I remember reading that.
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and they should do it all for an average joe wage... at least that's what I'm getting out of this thread.
Where does this 'average Joe wage' idea come from?
Most specifically from Barf who thinks that everybody involved in healthcare should take big paycuts because they all make too much money... especially the evil doctors.
The doctors should make less money...but not in their salaries. They shouldn't be given bonuses or sent on Caribbean vacations by the pharm companies in appreciation of scribing Ritalin for half of the middle school. And they shouldn't be paid by the procedure in a manner that encourages needless operations.
I'm all for them getting paid...just not how they're getting paid.
Health care in America - public or private - will remain broken so long as it a maximum profit industry.
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"If private insurers say that the marketplace provides the best quality health care ... then why is it that the government, which they say can't run anything, suddenly is going to drive them out of business?" Obama said in response to a question at a White House news conference.
"That's not logical," he scoffed, responding to an industry warning that government competition would undermine the employer coverage.
Cause he's an idiot and can't understand that a business owner isn't going to pay for or subsidize something his employees can get for free from the government.
Amen Florida... the government isn't going to run them out of business because their plan is BETTER.... the government is going to run them out of business because their plan is FREE....
yebat' Putin
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The current model where bills you don't understand just keep coming, and when you call they can't be explained doesn't work for me.
I've gotten bills up to 9 months after service...My dad lived with us for some time before he passed...bills came in for several months..One bill we called on we asked what service you did for my dad on Nov 20th... They ran of a list of things...i asked if they had any problems with the test...they said no... they changed tune alittle when i told them my dad died in Oct....and we still had to fight that bill....
nordawg
Amazing.... and I'm sure, not at all uncommon. Whether it's fraud or incompetence doesn't really matter to the consumer in the end, it's just another headache.
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I think you gotta be either a true lefty or an idiot to not see that his plan would eventually lead to single payer. He's just playing politics... Myself, I can't see how single payer solves much... but if he's true to his word and he objectively looks at all solutions on the table. Then I think he'll see it my way 
"I'm a mog. Half man, half dog. I'm my own best friend."
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I think you gotta be either a true lefty or an idiot ...
What's the difference? Sorry.. it's a JOKE!!!!!
yebat' Putin
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Look at it this way. The ENTIRE Library of Congress would probably fit on about 20 TB of storage. Thats EVERYTHING...The Cleveland Clinic alone goes through well over 150 TB of storage EVERY YEAR, just for things like X-Rays, CT's, MRI's, etc......just image data...no patient data or dictations or anything les like that...JUST image data. Then they have to have machines that Store that information, make that information available to the docs and radiologists who need it, they have to have databases and applications that manage the images and data that go along with them, they have to have High Powered Graphics machines to view the images. All of this has to be supported. And we didn't even get to the people who actually performed the X-Ray itself....
If they can store all that, WHY do they tell you to bring your MRI films with you every time you go for a DR. visit?
I AM ALWAYS RIGHT... except when I am wrong.
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Cause he's an idiot
That sums the whole thing up in a nutshell
I AM ALWAYS RIGHT... except when I am wrong.
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Depends on where you had your MRI Done and who is looking at them....
If you had your MRI done At the Clinic and you have a Clinic Doc looking at them...then they wouldn't be asking you to do that. But if you had your MRI done at an outside hospital...and then you go to the Clinic, say for a 2nd opinion....Well then you may be asked to bring either a hard copy (films) or a Disc with your images on it.....When you have the Disc you then have to worry about compatability and the viewer for the image is usually included on the Disc.
I thought I was wrong once....but I was mistaken...
What's the use of wearing your lucky rocketship underpants if nobody wants to see them????
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Posts: 2,667
Dawg Talker
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Dawg Talker
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Just to add...remember that if your PCP has his own private practice then he is not in the network with most of the Hospitals computer systems...( Although that is starting to change with some pretty robust and secure software...Some interesting stuff that I don't fully understand yet...but it is coming...
So if your PCP is not connected to the network, then he doesn't have access to your images.
I thought I was wrong once....but I was mistaken...
What's the use of wearing your lucky rocketship underpants if nobody wants to see them????
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Posts: 27,588
Legend
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Legend
Joined: Sep 2006
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Cleveland Clinic, and they still want the hard copy
I AM ALWAYS RIGHT... except when I am wrong.
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Joined: Sep 2006
Posts: 2,667
Dawg Talker
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Dawg Talker
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To further add...if you had your procedures done at the Clinic...even if for an outside PCP...and then you were then in an emergency situation where they took you to ANY of the Cleveland Clinic Hospitals or Family Health Centers...They would have the ability if necessary to pull up those prior images to assist in your treatment. So regardless of you having an CT scan at South Point Hospital 5 years ago. If you were taken to Hillcrest Hospital for an Emergency....They can pull those images...and quite quickly I might add...to give you the best possible care.
I thought I was wrong once....but I was mistaken...
What's the use of wearing your lucky rocketship underpants if nobody wants to see them????
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Joined: Sep 2006
Posts: 19,176
Legend
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Legend
Joined: Sep 2006
Posts: 19,176 |
Quote:
And when it comes to something like a sling I'm pretty capable of putting it on myself.
But if you were one of the few morons who couldn't or wouldn't, a lawyer would get you a fortune if all of the many costly yet frivolous safeguards weren't followed.
And into the forest I go, to lose my mind and find my soul.
- John Muir
#GMSTRONG
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Legend
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Legend
Joined: Sep 2006
Posts: 30,887 |
Quote:
Quote:
And when it comes to something like a sling I'm pretty capable of putting it on myself.
But if you were one of the few morons who couldn't or wouldn't, a lawyer would get you a fortune if all of the many costly yet frivolous safeguards weren't followed.
Excellent point!!!!! 
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Legend
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Legend
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http://www.youtube.com/v/S39MhPrLQz4This is pretty funny and sadly accurate..."but we'll also send a bill to you, just to see if you'll pay it."
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Legend
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Legend
Joined: Sep 2006
Posts: 11,367 |
Government Health Plans Always Ration Care Europe offers a glimpse of the future if President Obama and congressional Democrats have their way. By SCOTT GOTTLIEB Only by expanding government control of health care can we bring down its cost. That's the faulty premise of the various proposals for health reform now being batted around Washington. The claimed cost control depends on politically safe ideas such as preventive care or the adoption of electronic health records. And neither -- even according to the Congressional Budget Office -- will do much to reduce spending. If these proposals are implemented and fail to produce savings, government will turn to a less appealing but more familiar tool to cut costs: the regulation of access to drugs and medical services. Medicare is already going down this path. What will be new about government-run health care is the instrument of regulatory control. There will be an omnipotent federal health board. Buried in current reform proposals, this board deserves closer scrutiny. Our best look at this construct comes from a bill released by the Senate Health, Education, Labor and Pensions (HELP) Committee. The bill calls for a "Medical Advisory Council" to determine what medical products and services are "essential benefits" and those that shouldn't be covered by a public insurance plan. The Senate Finance Committee turns to a "Federal Health Board" to compare similar medical treatments in order to steer reimbursement to lower-cost options. Senate Finance also proposes a "sustainability commission" charged with finding automatic cuts to Medicare spending that would then pass Congress by a simple up or down vote. Meanwhile, a draft health-care reform proposal introduced last week in the House of Representatives by the three committees with jurisdiction over health policy set up an independent "advisory committee" that will "recommend a benefit package based on standards set in the law." It also proposes a new "commission" that may, among other things, help develop treatment protocols based on government-directed research. Congress, of course, can authorize the creation of panels and commissions to provide expert advice to the executive branch. But such bodies are typically advisory, and their advice is free to be rejected or modified by the president. Under the HELP committee's plan, the health board's recommendations would be binding unless Congress acts within a brief period to pass a "joint resolution disapproving such report in its entirety." President Obama objects when people use the word "rationing" in regards to government-run health care. But rationing is inevitable if we simply expand government control without fixing the way health care is reimbursed so that doctors and patients become sensitive to issues of price and quality. Like Medicare's recent decisions to curtail the use of virtual colonoscopies, certain wound-healing devices, and even a branded asthma drug, the board's decisions will be one-size-fits-all restrictions. Such restrictions don't respect variation in preferences and disease, which make costly products suitable for some even if they are wasteful when prescribed to everyone. Moreover, these health boards prove that policy makers know they'll need to ration care but want to absolve themselves of responsibility. Some in Congress and the Obama administration recently tipped their hand on this goal by proposing to make recommendations of the current Medicare Payment Advisory Committee (MedPAC) legally binding rather than mere advice to Congress. Any new health board's mission will also expand over time, just as MedPAC's mandate grew to encompass medical practice issues not envisioned when it was created. The idea of an omnipotent board that makes unpopular decisions on access and price isn't a new construct. It's a European import. In countries such as France and Germany, layers of bureaucracy like health boards have been specifically engineered to delay the adoption of new medical products and services, thus lowering spending. In France, assessment of medical products is done by the Committee for the Evaluation of Medicines. Reimbursement rates are set by the National Union of Sickness Insurance Funds, a group that also negotiates pay to doctors. In Germany, the Federal Joint Committee regulates reimbursement and restrictions on prescribing, while the Institute for Quality and Efficiency in Healthcare does formal cost-effectiveness analysis. The Social Insurance Organization, technically a part of the Federal Joint Committee, is in charge of setting prices through a defined formula that monitors doctors' prescribing behavior and sets their practice budgets. In the past 12 months, the 15 medical products and services that cleared this process spent an average 35 months under review. (The shortest review was 19 months, the longest 51.) In short, other countries where government plays a large role in health care aren't shy about rationing. Mr. Obama's budget director has acknowledged that rationing reduces costs. Peter Orszag told Congress last year when he headed the Congressional Budget Office that spending can be "moderated" if "diffusion of existing costly services were slowed." Medicare can already be painstakingly slow. Appealing to it takes patients an average 21 months according to a 2003 Government Accountability Office report (17 months involve administrative processing). Layers of commissions and health boards would delay access still further. When asked to judge the constitutionality of the Senate HELP committee proposal, there's a reason why the nonpartisan Congressional Research Service said that the proposed Medical Advisory Council "raises potentially significant constitutional concerns." Our Founders thought politicians should be accountable when it comes to citizens' right to life, liberty and the pursuit of heart surgery. http://online.wsj.com/article/SB124588779662250705.html
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Legend
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Legend
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There's a significant reason that wealthy foreigners come to the United States for their health care... it is because the "one size fits all" nationalized health care in Europe sucks.
Browns is the Browns
... there goes Joe Thomas, the best there ever was in this game.
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Joined: Sep 2006
Posts: 30,887
Legend
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Legend
Joined: Sep 2006
Posts: 30,887 |
Quote:
There's a significant reason that wealthy foreigners come to the United States for their health care... it is because the "one size fits all" nationalized health care in Europe sucks.
And canada - you forgot that one.
Do we really want health care that does this?: True story. A friend and his wife, we met at Bristol 10 years ago at the race - we've camped beside them every year since - they are from Canada. He and I have talked about health care "systems" for years. He is 63 now. Well, he and his wife were planning on coming down here on their way to the august race at Bristol - spend 3 or 4 days at our place.
Well, he called last week. Turns out he's not allowed to come to the states. It seems that in March, as we were walking back from the track - he had a heart attack. Now, mind you, his "symptoms" were shortness of breath. I hung back with him while the rest of the group kept walking - I even told him "hey, I know cpr if you're having a heart attack", and I said it in a joking manner. Well, when he got back to canada he went to a doctor - and lo and behold, they said he HAD had a heart attack.
Now? He's not allowed to travel to the U.S. - well, he can, but if anything happens to him, heart related, while he's here, he's on his own and will have to pay for his own care.
Do we want a system of health care that tells you what you can and cannot do?
His father in law died the week we were in Bristol - in fact, his wife left a few days before the race to be with her dad. Now, he had been sick for a while. Why did he die? He had several problems, but the tumor that killed him had gone undiagnosed - because he "was in line to have an MRI next month".
Is that the kind of health care we want?
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Posts: 11,465
Legend
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Legend
Joined: Sep 2006
Posts: 11,465 |
Quote:
President Obama objects when people use the word "rationing" in regards to government-run health care. But rationing is inevitable if we simply expand government control without fixing the way health care is reimbursed so that doctors and patients become sensitive to issues of price and quality.
This whole 'rationing' thing kills me...I don't think we could possibly 'ration' care any worse than we do now.
I'm continually on the fence with this one...our current system is beyond horrid...but I don't trust the gov't to do much in the way of health care...
With that said...the argument against gov't intervention is absolutely absurd, often times downright illogical. I'm not talking about the stance itself, but rather the arguments presented.
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Joined: Sep 2006
Posts: 11,367
Legend
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Legend
Joined: Sep 2006
Posts: 11,367 |
Quote:
This whole 'rationing' thing kills me...I don't think we could possibly 'ration' care any worse than we do now.
You can't possibly be as ignorant or irrational as you are portraying yourself on this subject.
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